[Clinical characteristics and efficacy of vocal fold epidermoid cysts coexisting with sulcus vocalis].

Objective: To investigate the clinical characteristics and voice outcomes after laryngeal microsurgery for vocal fold epidermoid cysts coexisting with sulcus vocalis. Methods: The clinical data of 115 vocal fold epidermoid cysts coexisting with sulcus vocalis patients in Shandong provincial ENT hospital, were retrospectively analyzed, including 49 males and 66 females, aged 17-70 years old, and the duration of hoarseness ranged from 6 months to 30 years. All patients underwent surgery through suspension laryngoscope and microscope under general anestgesia. Ninety-four patients were treated with microflap excision of sulcus vocalis, cyst wall, and contents.And 21 patients that occulted with mucosal bridges were applied mucosal bridges resection (2 cases) and mucosal bridges reconstruction (19 cases) respectively. Videolaryngoscopy, subjective voice evaluation (GRBAS), objective voice evaluation, and Voice Handicap Index(VHI) were performed before and after surgery. All patients underwent histopathologic examination and follow-up after the procedure. The preoperative acoustic parameters of patients with vocal fold epidermoid cysts coexisting with sulcus vocalis were compared with those of vocal fold mucus retention cysts and simple vocal fold epidermoid cysts by independent samples t-test. The patients were compared by paired t-test for preoperative and postoperative parameters. Results: Significant reduction or lack of mucosal waves were shown via videolaryngostroboscopy in all 115 cases.In addition, vascular changes including dilation, tortuousness, increased branches, and abrupt direction change were shown on the cystic area. Eighty-one patients were detected cysts and/or sulcus vocalis by preoperative laryngoscopy, and intraoperative microscopic findings in the remaining 34 patients. The intraoperative microscopic examination revealed a focal pouch-like deficit plunging into the vocal ligament or muscle. The deep surface of the mucosal bridges was sulcus vocalis, and that in 89 cysts was lined with caseous content. Histopathology demonstrated a cystic cavity structure lined with squamous epithelium and caseous keratin desquamation inside the cystic cavity. Four of 115 patients were lost at follow-up and excluded from the analysis of voice outcomes after surgery. There was no significant mucosal wave and the voice quality in all but 14 patients 1month after surgery. Except for the fundamental frequency and noise harmonic ratio, all other voice parameters[ G, R, B, A, VHI-10, jitter, shimmer, maximum phonatory time (MPT) ]showed a significant improvement 3 months after surgery(t=15.82, 20.82, 17.61, 7.30, 38.88, 7.84, 5.88, -6.26, respectively, P<0.05). Then mucosal waves and the voice quality were gradually improved and became steady in 6 months after surgery. The subjective and objective voice parameters[G, R, B, A, VHI-10, jitter, shimmer, noise to harmonic ratio(NHR), MPT], except for the fundamental frequency, were all significantly improved(t=23.47, 25.79, 18.37, 9.84, 54.45, 10.68, 8.07, 3.24, -9.08, respectively, P<0.05). In addition, there were 2 patients with no significant improvement after the operation. Steady function with no complications was observed during the 12 months (up to 3 years in 34 patients) follow-up period in 111 patients. Conclusion: Ruptured vocal fold epidermoid cysts can result in sulcus vocalis and mucosal bridges. Characteristics changes in preoperative videolaryngoscopy are effective diagnostic tools. The complete excision of the cyst wall and repair of the lamina propria can lead to satisfactory long-term effects.

[Demethylzeylasteral inhibits proliferation, migration and invasion and promotes apoptosis of non-small cell lung cancer cells by inhibiting the AKT/CREB signaling pathway].

OBJECTIVE: To investigate the mechanism underlying the inhibitory effects of Demethylzeylasteral (T-96) on non-small cell lung cancer (NSCLC) cells. METHODS: We first examined the effects of different concentrations (1, 3, 10, and 30 µmol/L) of demethylzeylasteral on morphology and cell number of A549 and H1299 cells. The changes in proliferation, cell viability, migration, invasion, and apoptosis of A549 and H1299 cells following demethylzeylasteral treatment were detected using clone formation, CCK-8, cell scratch, Transwell, and flow cytometric assays, and the effect of SC79 treatment against demethylzeylasteral-induced cell apoptosis was assessed. Western blotting was performed to detect the changes in expressions of E-cadherin, N-cadherin, vimentin, Bax, Bcl-2 and cleaved caspase-3 and phosphorylation of AKT/CREB in demethylzeylasteral-treated A549 and H1299 cells and the cellular expressions of apoptotic proteins following treatment with both demethylzeylasteral and SC79. RESULTS: T-96 treatment caused elongation of the cell body and widening of the intercellular space and significantly inhibited cell viability, proliferation, migration and invasion of A549 and H1299 cells (P < 0.05). Flow cytometry showed that demethylzeylasteral induced apoptosis in both A549 and H1299 cells, whereas SC79 treatment obviously attenuated its pro-apoptotic effect (P < 0.05). Western blotting revealed up-regulated expressions of Bax and cleaved caspase-3 proteins and lowered Bcl-2 expression level in demethylzeylasteral-treated A549 and H1299 cells, but cotreatment with SC79 obviously attenuated the expressions of the apoptotic proteins. T-96 significantly up-regulated the expression level of E-cadherin, down-regulated the expressions of N-cadherin and vimentin, and inhibited the phosphorylation of AKT and CREB in the two cell lines (P < 0.05). CONCLUSION: T-96 inhibits the proliferation, migration and invasion and induces apoptosis of NSCLC cells possibly by inhibiting the AKT/CREB signaling pathway.

[Liposome nanoparticles for targeted delivery of parthenolide induce colorectal cancer necroptosis to ameliorate tumor-infiltrating T cell exhaustion in mice].

OBJECTIVE: To investigate the mechanism of parthenolide for inducing necroptosis and ameliorating CD8+ T cell exhaustion in colorectal cancer (CRC) and construct liposome nanoparticles for targeted delivery of parthenolide. METHODS: The inhibitory effect of parthenolide on proliferation of different CRC cell lines was examined using CCK8 assay, and ROS LDH detection and Western blotting were used to analyze the cell death pathways. In a mouse model bearing subcutaneous MC38 cell xenografts, the effects of 5 and 15 mg/kg parthenolide on tumor growth and CD8+ T cell depletion were observed. In a mouse model bearing orthotopic CRC cell xenograft in the ileocecal region, free parthenolide (100 µg/mL) or low (100 µg/mL) and high doses (200 µg/mL) of liposome nanoparticles loaded with parthenolide were injected via the tail vein, and the changes in CD8 expression in the xenografts were analyzed using immunohistochemistry. RESULTS: Treatment with parthenolide dose-dependently lowered the viability of the CRC cell lines SW480, DLD1, HCT116 and MC38 cells, and its effect was obviously antagonized by Nec-1. Immunoblotting analysis showed that parthenolide treatment resulted in increased RIP3 and MLKL phosphorylation in the CRC cells. In the mouse model bearing subcutaneous xenografts, parthenolide treatment at the high dose, but not at the low dose, significantly increased the number of infiltrating CD3+ CD8+ T cells and PD1hiTIM3+ T cell percentage (P<0.01) and lowered the percentage of PD1loTIM3- T cells in the tumor tissue (P<0.01). In the mouse models bearing orthotopic CRC xenograft, intravenous injection of the liposomes loaded with parthenolide, especially at the high dose, significantly increased CD8 expression in the tumor tissue (P<0.01). CONCLUSION: Parthenolide induces necroptosis in CRC and increases infiltrating CD8+ T cells to ameliorate CD8+ T cell exhaustion in the tumor. Liposome nanoparticles for targeted delivery of parthenolide produce stronger, anti-tumor effect.

[Human amniotic membrane plug for recurrent retinal detachment associated with pathologic myopic macular hole].

A 60-year-old woman presented with a history of "pathological myopia combined with macular hole retinal detachment, " for which she underwent vitrectomy, internal limiting membrane tamponade, and silicone oil filling surgery one year ago. Seven months ago, the silicone oil was removed. She now returned to seek medical attention as her visual acuity has declined by 10 diopters. Examination revealed a recurrence of macular hole retinal detachment. The patient was treated with combined amniotic membrane tamponade and silicone oil filling. During the surgery, the frozen amniotic membrane was cut into 2 mm × 2 mm and placed under the macular hole retina after silicone oil filling. Within 6 months after the surgery, her retina repositioned well, the macular hole closed, and her visual function improved from hand motion to 0.05. No severe complications were observed. Therefore, this surgical approach provides a new perspective for treating recurrent pathological myopia combined with macular hole retinal detachment.

[Outcomes at discharge of preterm infants born <34 weeks' gestation].

Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.

Treponema denticola Promotes OSCC Development via the TGF-ß Signaling Pathway.

Numerous studies have demonstrated an association between periodontitis and oral squamous cell carcinoma (OSCC), and periodontal pathogens such as Treponema denticola are implicated in the pathogenesis of OSCC. Previous studies have mainly focused on T. denticola surface proteins-for example, chymotrypsin-like proteinase, which was detected in the majority of orodigestive tumor tissues.T. denticola may influence the development of OSCC. Nevertheless, the potential direct regulatory mechanism of T. denticola in OSCC is still unclear. Therefore, this study aimed to explore the direct effect of T. denticola on OSCC cell proliferation and elucidate potential mechanisms of T. denticola in contributing to cell proliferation. A series of in vitro experiments (e.g., CCK-8, EdU, flow cytometry) were performed to explore the effect of T. denticola on cell proliferation, cell cycle, and apoptosis. Mice experiments were performed to explore the effect of T. denticola on tumor growth. Whole mRNA transcriptome sequencing and quantitative real-time polymerase chain reaction were performed to explore the intracellular signaling pathway. Our study found that T. denticola could invade Cal-27 cells and directly promote cell proliferation, regulate the cell cycle, and inhibit apoptosis. T. denticola could also promote the growth of OSCC tumors in mice, and it upregulated Ki67 expression. Regarding the mechanism, T. denticola could promote the development of OSCC by activating the TGF-ß pathway. In conclusion, T. denticola could promote OSCC cell proliferation directly, and the mechanism was associated with intracellular TGF-ß pathway activation.

Nomogram to predict survival of patients with advanced and metastatic pancreatic Cancer.

BACKGROUND: Nomograms are rarely employed to estimate the survival of patients with advanced and metastatic pancreatic cancer (PC). Herein, we developed a comprehensive approach to using a nomogram to predict survival probability in patients with advanced and metastatic PC. METHODS: A total of 323 patients with advanced and metastatic PC were identified from the Chinese People's Liberation Army (PLA) General Hospital. A baseline nomogram was constructed using baseline variables of 323 patients. Additionally, 233 patients, whose tumors showed initial responses to first-line chemotherapy, were enrolled in the chemotherapy response-based model. 128 patients and 108 patients with advanced and metastatic PC from January 2019 to April 2021 were selected for external validating baseline model and chemotherapy response-based model. The 1-year and 2-year survival probability was evaluated using multivariate COX regression models. The discrimination and calibration capacity of the nomograms were assessed using C-statistic and calibration plots. The predictive accuracy and net benefit of the nomograms were evaluated using ROC curve and DCA, respectively. RESULTS: In the baseline model, six variables (gender, KPS, baseline TB, baseline N, baseline WBC and baseline CA19-9) were used in the final model. In the chemotherapy response-based model, nine variables (KPS, gender, ascites, baseline N, baseline CA 19-9, baseline CEA, change in CA 19-9 level at week, change in CEA level at week and initial response to chemotherapy) were included in the final model. The C-statistics of the baseline nomogram and the chemotherapy response-based nomogram were 0.67 (95% CI, 0.62-0.71) and 0.74 (95% CI, 0.69-0.77), respectively. CONCLUSION: These nomograms were constructed to predict the survival probability of patients of advanced and metastatic PC. The baseline model and chemotherapy response-based model performed well in survival prediction.

Identification of DNA methylation-driven genes and construction of a nomogram to predict overall survival in pancreatic cancer.

BACKGROUND: The incidence and mortality of pancreatic cancer (PC) has gradually increased. The aim of this study was to identify survival-related DNA methylation (DNAm)-driven genes and establish a nomogram to predict outcomes in patients with PC. METHODS: The gene expression, DNA methylation database, and PC clinical samples were downloaded from TCGA. DNAm-driven genes were identified by integrating analyses of gene expression and DNA methylation data. Survival-related DNAm-driven genes were screened via univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses to develop a risk score model for prognosis. Based on analyses of clinical parameters and risk score, a nomogram was built and validated. The independent cohort from GEO database were used for external validation. RESULTS: A total of 16 differentially expressed methylation-driven genes were identified. Based on LASSO Cox regression and multivariate Cox regression analysis, six genes (FERMT1, LIPH, LAMA3, PPP1R14D, NQO1, VSIG2) were chosen to develop the risk score model. In the Kaplan-Meier analysis, age, T stage, N stage, AJCC stage, radiation therapy history, tumor size, surgery type performed, pathological type, chemotherapy history, and risk score were potential prognostic factors in PC (P < 0.1). In the multivariate analysis, stage, chemotherapy, and risk score were significantly correlated to overall survival (P < 0.05). The nomogram was constructed with the three variables (stage, chemotherapy, and risk score) for predicting the 1-year, 2-year, and 3-year survival rates of PC patients. Nomogram performance was assessed by receiver operating characteristic (ROC) curves and calibration curves. 1-year, 2-year and 3-year AUC of nomogram model was 0.899, 0.765 and 0.776, respectively. CONCLUSIONS: In our study, we successfully identified the six DNAm-driven genes (FERMT1, LIPH, LAMA3, PPP1R14D, NQO1, VSIG2) with a relationship to the outcomes of PC patients. The nomogram including stage, chemotherapy, and risk score could be used to predict survival in PC patients.

Worldwide cancer statistics of adolescents and young adults in 2019: a systematic analysis of the Global Burden of Disease Study 2019.

BACKGROUND: The cancer burden in adolescents and young adults (AYAs) deserves more attention. However, global cancer statistics for AYAs are often presented as aggregates, concealing important heterogeneity. This study aimed to describe the worldwide profile of cancer incidence, mortality, and corresponding trends from 1990 to 2019 among 15-39-year olds by focusing on the patterns by age, sex, sociodemographic index (SDI), and regions. PATIENTS AND METHODS: Global, regional, and country data on the number of cancer cases and cancer-related deaths for 29 cancer types were collected from the 2019 Global Burden of Disease (GBD) Study. We also summarized the results using five levels of the SDI and 21 GBD regions. RESULTS: In 2019, an estimated 1 335 100 new cancer cases and 397 583 cancer-related deaths occurred among AYAs worldwide. While the incidence rate increased mildly, the death rate decreased significantly between 1990 and 2019, with an estimated annual percentage change of 0.38 (95% confidence interval 0.36-0.39) and -0.93 (95% confidence interval -0.95 to -0.92), respectively. The cancer burden was disproportionally greater among women than among men. The cancer profiles varied substantially across geographical regions, with the highest burden being in South Asia and East Asia. Besides, the cancer incidence in the high SDI regions was four times higher than that in the low SDI regions; however, the mortality burden in the high SDI region was lower than that in the low SDI region, which reflected the differences in cancer profiles across SDI regions and the inferior outcomes in the low SDI regions. CONCLUSION: This study updates the previous epidemiological data of the cancer burden of AYAs. The cancer burden in AYAs varied substantially according to age, sex, SDI, and geographical regions. These findings highlight that the specific cancer profile of AYA patients requires targeted cancer control measures to reduce the cancer burden in this age group.

Association of Neighborhood Deprivation Index With Success in Cancer Care Crowdfunding.

Importance: Financial toxicity resulting from cancer care poses a substantial public health concern, leading some patients to turn to online crowdfunding. However, the practice may exacerbate existing socioeconomic cancer disparities by privileging those with access to interpersonal wealth and digital media literacy. Objective: To test the hypotheses that higher county-level socioeconomic status and the presence (vs absence) of text indicators of beneficiary worth in campaign descriptions are associated with amount raised from cancer crowdfunding. Design, Setting, and Participants: This cross-sectional analysis examined US cancer crowdfunding campaigns conducted between 2010 and 2019 and data from the American Community Survey (2013-2017). Data analysis was performed from December 2019 to March 2020. Exposures: Neighborhood deprivation index of campaign location and campaign text features indicating the beneficiary's worth. Main Outcomes and Measures: Amount of money raised. Results: This study analyzed 144 061 US cancer crowdfunding campaigns. Campaigns in counties with higher neighborhood deprivation raised less (-26.07%; 95% CI, -27.46% to -24.65%; P < .001) than those in counties with less neighborhood deprivation. Campaigns raised more funds when legitimizing details were provided, including clinical details about the cancer type (9.58%; 95% CI, 8.00% to 11.18%; P < .001) and treatment type (6.58%; 95% CI, 5.44% to 7.79%; P < .001) and financial details, such as insurance status (1.39%; 95% CI, 0.20% to 2.63%; P = .02) and out-of-pocket costs (7.36%; 95% CI, 6.18% to 8.55%; P < .001). Campaigns raised more money when beneficiaries were described as warm (13.80%; 95% CI, 12.30% to 15.26%; P < .001), brave (15.40%; 95% CI, 14.11% to 16.65%; P < .001), or self-reliant (5.23%; 95% CI, 3.77% to 6.72%; P < .001). Conclusions and Relevance: These findings suggest that cancer crowdfunding success ay disproportionately benefit those in high-socioeconomic status areas and those with the internet literacy necessary to portray beneficiaries as worthy. By rewarding those with existing socioeconomic advantage, cancer crowdfunding may perpetuate socioeconomic disparities in cancer care access. The findings also underscore the widespread nature of financial toxicity resulting from cancer care.

[Research progress of curcumin in the prevention and treatment of periodontitis].

Curcumin is a plant-derived polyphenol extracted from the rhizome of turmeric. As curcumin has such favorable properties as anti-inflammation, anti-oxidation, anti-angiogenesis, immune regulation, anti-bacterial and pro-apoptosis and showed few side effects, the application of curcumin in prevention and treatment of periodontal diseases is promising. This article reviewed the research progress of curcumin in the prevention and treatment of periodontitis.

[Short-term outcomes of modified load-sharing rip-stop repair compared with suture-bridge repair for large rotator cuff tears].

Objective: To examine the short-term outcomes of modified load-sharing rip-stop repair (mLSRS) and suture-bridge repair (SB) for large rotator cuff tear. Methods: The clinical data of patients who underwent shoulder arthroscopy for large rotator cuff repair at Department of Orthopedic, China Academy of Chinese Medical Sciences Wang Jing Hospital from January 2017 to December 2018 were collected. Totally 111 patients (39 in mLSRS group and 72 in SB group) were included in the study. There were 45 males and 66 females, aged (58.0±6.9)years (range: 40 to 72 years).A total of 39 pairs of patients were successfully matched by propensity score matching. The pain of shoulder joint was assessed by visual analogy score (VAS) , the shoulder function was assessed by Constant-Murley score, the abduction strength of bilateral shoulder joint was assessed by 90˚ force assessment method of upper limb on the plane of scapula, and the healing of rotator cuff on the operative side was assessed by sugaya ultrasonic classification standard. The difference of short-term outcome between the two groups were compared using t test, χ(2) test, Mann-Whitney U test, repeated measures design anova and multivariate analysis of variance. Results: At the 4th week after surgery, the VAS of mLSRS group was significantly lower than SB group(1 (2) vs. 2 (2) , F=5.32, P=0.02). One year after surgery, Constant-Murley score of two groups were significantly higher than those before surgery, but there was no significant difference between two groups(89.1±5.7 vs. 87.6±7.3, t=1.00, P=0.32). Abductor strength of affected limbs were lower than that of the opposite side, but there were no statistically significant differences between two groups(4.28±1.61 vs. 4.54±1.64, t=-0.70, P=0.49). According to the Sugaya classification, 32 cases in mLSRS group were healed while 7 cases were not healed,30 cases in SB group were healed while 9 cases were not healed(χ(2)=0.32, P=0.58). Conclusion: The use of mLSRS fixation construct on large rotator cuff tear can reduce pain and the short-term outcome is reliable.

The association of hematuria on kidney clinicopathologic features and renal outcome in patients with diabetic nephropathy: a biopsy-based study.

PURPOSE: To investigate the relationships between hematuria, clinicopathological features and renal outcomes in patients with biopsy-proven diabetic nephropathy (DN). METHODS: This cohort study included 261 patients with DN. Participants were divided into two groups according to number of red blood cells per high-power field (RBC/hpf) in urine sediment: the hematuria (-) group (≤ 3 RBC/hpf) and the hematuria (+) group (> 3 RBC/hpf). Basic clinical parameters were measured at the time of renal biopsy; relationships between hematuria and clinicopathological features and renal outcomes were analyzed. RESULTS: Patients in the hematuria (+) group often had overt proteinuria. Interstitial inflammation was more severe in the hematuria (+) group than in the hematuria (-) group. Glomerular arteriolar hyalinosis, interstitial fibrosis and tubular atrophy were comparable between groups. For patients with early DN (eGFR ≥ 60 ml/min/1.73 m2), urinary RBC/hpf at baseline was positively correlated with glomerular classification, interstitial fibrosis/tubular atrophy scores and interstitial inflammation scores. In prognostic analysis, hematuria was associated with a higher risk of progression to end-stage renal disease. Hematuria remained an independent predictor after adjustment for confounding factors such as sex, age, duration of diabetes, serum glucose level, hypertension, cholesterol, eGFR and urine protein excretion, especially in patients with early DN and in male patients. CONCLUSION: In this study, hematuria was associated with more severe renal pathologic lesions in patients with DN. The presence of hematuria could be an independent predictor of renal outcome in patients with early DN.

[Value of coarse needle biopsy in thyroid nodules as first-line diagnostic tool].

Objective:By retrospectively analyzing the results of ultrasound guided coarse needle biopsy（CNB） of thyroid nodules based on large samples, so as to evaluate its diagnostic value as first-line diagnostic tool for thyroid nodules. Method:From October 2015 to November 2017, a total of 508 nodules were studied from 474 patients who underwent CNB in general surgery department of tianjin first central hospital. The nondiagnostic rate, inconclusive rate, unnecessary surgery rate and complication rate of thyroid nodules diagnosed by CNB were calculated. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CNB in thyroid cancer diagnosis were analyzed. The correlation between inconclusive diagnostic results and ultrasonic findings like echogenicity, composition, margin, calcification type, blood supply and nodule size was analyzed. Result:The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CNB diagnosis were 97.27%, 99.17%, 99.07%, 99.45% and 99.36%, respectively. However, the nondiagnostic rate, the inconclusive rate, the conclusive rate and the unnecessary surgery rate of thyroid nodules diagnosed by CNB were 2.95%, 7.09%, 92.92% and 1.86%, respectively. Conclusion:Ultrasound guided coarse needle biopsy might be safe and reliable for the diagnosis of thyroid nodules, with relatively stable diagnostic effect. It is not only of high diagnostic value but also can significantly reduce diagnostic surgery. Therefore, CNB could be the preferred examinational method for nodules with suspicious ultrasonic findings.

Research on the correlation of changes in plasma lncRNA MEG3 with change in inflammatory factors and prognosis in patients with traumatic brain injury.

OBJECTIVE: To study the correlation between the plasma long non-coding RNA (lncRNA) maternally expressed gene 3 (MEG3) and the levels of inflammatory cytokines in patients with traumatic brain injury (TBI) and to evaluate its prognosis to screen new biological targets for the diagnosis and treatment of TBI. PATIENTS AND METHODS: 40 patients with TBI (TBI group) and 40 healthy people (control group) were collected and venous blood was drawn. The plasma MEG3 in subjects was quantitatively analyzed via quantitative Polymerase Chain Reaction (qPCR). Moreover, the levels of inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), IL-6, and IL-8] in plasma in each group were detected via enzyme-linked immunosorbent assay (ELISA). Finally, the correlation analysis was performed for the MEG3 expression level and inflammatory cytokine levels in patients with TBI. Patients were divided into high-expression MEG3 group and low-expression MEG3 group, high-level inflammatory cytokine group and low-level inflammatory cytokine group according to the median, followed by prognosis evaluation. The MEG3 expression level in TBI group was significantly decreased compared to that in control group, and the levels of inflammatory cytokines in plasma, including TNF-α, IL-1ß, IL-6, and IL-8, were significantly higher than in control group. RESULTS: The results of the correlation analysis showed that the expression level of plasma MEG3 had a significantly negative correlation with the level of each inflammatory cytokine. The prognostic analysis revealed that the prognosis of patients with high MEG3 expression level and low inflammatory cytokine levels was good, while it was poor in patients with low MEG3 expression level and high inflammatory cytokine levels; the difference was significant. In patients with TBI, the expression level of plasma MEG3 is decreased, while the inflammatory cytokine levels are increased, and there is a significantly negative correlation between the two items. CONCLUSIONS: The prognosis of patients with high MEG3 expression level and low inflammatory cytokine levels is good so MEG3 and inflammatory cytokines can be used as biomarkers for diagnosis and treatment of TBI, improving the prognosis of patients.

The long non-coding RNA AK001796 contributes to poor prognosis and tumor progression in hepatocellular carcinoma.

OBJECTIVE: Increasing studies have indicated the important functions of long non-coding RNAs (lncRNAs) in tumorigenesis and progression including hepatocellular carcinoma (HCC). The study aims to explore the role of long non-coding RNA AK001796 in HCC progression. PATIENTS AND METHODS: Quantitative Real-time polymerase chain reaction (QRT-PCR) analysis was performed to examine the lncRNA AK001796 expression in 73 cases of human HCC tissue samples and matched adjacent normal tissues. Besides, the relationship between lncRNA AK001796 expression and clinicopathologic characteristics was analyzed. Overall survival (OS) curves of patients were constructed by the Kaplan-Meier methods. Multivariate Cox regression analysis was used to evaluate independent risk factors affecting HCC prognosis. Cell proliferation and invasion abilities are analyzed by cell counting kit-8 (CCK-8) and transwell invasion assays. RESULTS: We showed that the lncRNA AK001796 expression was significantly up-regulated in HCC tissues and cell lines, compared to their controls, respectively. Higher lncRNA AK001796 expression closely correlated with tumor size (p<0.05), TNM stage (p<0.05) and the poor overall survival (OS) rate of HCC patients (p<0.05). Besides, multivariate Cox regression analysis found that lncRNA AK001796 expression was identified as an independent risk factor for HCC prognosis. In vitro, we showed that lncRNA AK001796 knockdown markedly suppressed cell proliferation and cell invasion abilities. CONCLUSIONS: Our results suggested that lncRNA AK001796 acts as a predictor of HCC prognosis and may provide an important clinical value for HCC treatment.

[Pathophysiologic mechanism of CMTM5 low expression in multiple myeloma progression].

Objective: To investigate the mechanism of chemokine-like factor superfamily member (CMTM) 5 on the proliferation of multiple myeloma cells. Methods: RT-qPCR method was used to detect the expression and correlation of CMTM5, caspase3 and caspase9 in U266 after decitabine demethylation treatment; U266 transfected with pcDNA3.1 plasmid overexpressed CMTM5, then cell proliferation activity was detected by CCK-8 assay. Results: Compared with the control group, the low-dose demethylation treatment increased mRNA expression of CMTM5, caspase3, and caspase9 in U266, and showed a time-dependent (P<0.01). The up-trend of CMTM5, caspase3, and caspase9 in the high-demethylation drug treatment group was more significant and also showed time-dependent (P<0.001); There was a significant positive correlation between CMTM5 and caspase3 (r=0.937) and caspase9 (r=0.945) in each group (P<0.001). After transfection of U266 with the pcDNA3.1-CMTM5 plasmid, overexpression of CMTM5 inhibited the cell proliferation activity compared with the control and pcDNA3.1-vector group. Conclusion: Decitabine has a reductive effect on the low level of CMTM5 in U266 cells, and its recovery level is significantly positively correlated with caspase 3 and caspase9. Re-expression of CMTM5 inhibits the proliferative activity of U266.

[Study on the relationship between age-related hearing loss and cognitive impairment].

Objective: To investigate the correlation between age-related hearing loss and cognitive impairment. Methods: 201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People's Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. Results: Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). Conclusions: Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

[Excision of thyroglossal cyst in children by transverse submentum incision].

Objective:To explore the application of transverse submentum incision in thyroglossal duct cyst surgery. Method:Submentum transverse incision for thyroglossal duct cyst removal in 14 children with thyroglossal duct cyst from January 2014 to December 2017. All cases were performed submentum dermatoglyphic incision, skin incision, subcutaneous tissue, platysma muscle incision, down lifting flap, along the white line incision and separation of banded muscle on both sides, see the mass along the wall of the capsule separated to the attachment of the hyoid bone, ablation of the mucosa of the capsule wall of the hyoid bone attachment, electrotome to break the hyoid bone. The cavity is indeed stopped after bleeding, and the skin is sutured continuously for continuous intradermal suture. The operation time, bleeding volume, severe complications, wound healing time and severe surgical scars were recorded. Close follow-up was performed to observe whether there was infection or recurrence of incisional wound. Parents were informed by telephone to go back to the outpatient clinic. RUTTER Children's Behavior Questionnaire was used to assess the children's psychological status. Vancouver Scar Rating Scale was used to evaluate the children's surgical scars, and to investigate whether parents satisfactory surgical methods. Result:Fourteen cases of thyroglossal duct cyst underwent transverse incision thyroglossal duct cyst excision successfully. The average operative time was 55 minutes, and the standard deviation was 10.5 min, bleeding was less than 10 ml, postoperative hoarseness and weakness of voice, silence became low, wound healing time averaged one week, no serious surgical scars, no wound infection and recurrence. Among the normal children of the same age group, 14 parents were satisfied with the operation. Conclusion:Excision of thyroglossal duct cyst under transverse incision is safe, reliable and satisfactory in appearance.